Careers in Medicine & Social Sciences

When I was deciding whether to apply MD/PhD, MD-only, or forego applying to medical school entirely, I relied upon the experiences and advice of senior trainees and faculty to help guide me. Eventually, I discovered MD/PhD researchers in health economics whose careers I wanted to emulate through reading academic papers in my undergraduate courses in economics. I had been interested in both economics and medicine throughout college and pursued the two in parallel as an undergraduate.

My general suggestion is to reach out to as many people as you can on each of these training paths. You can browse faculty profiles on academic department websites, reach out to authors of papers you like, or get references from mentors, PIs, and friends.

People love sharing their stories with others! Ask them about their careers, how they got to where they are, and what skills they feel that they lack and what they might have done differently in their training. At some point, you’ll stumble upon someone who makes you think, “I want to be just like him/her/them!” and you’ll have your answer.

Here are what I conceptualized to be the differences between different training paths/careers. Again, this may differ based on who you talk to, and this is just my opinion.

Read this first.

MD-Only     -     MD-MPH     -     MD-Master’s     -     PhD-Only     -     MD-PhD

MD-Only

A common misconception is that successful physician-scientists all have PhDs. This isn’t true. There are many physician-scientists who only have an MD, but have invested significant time into training as a researcher post-medical school, during residency, or even as an attending. However, the scope for research in health policy with only an MD is very limited. Training in health policy requires knowledge of methods and theory specific to the discipline, often necessitating coursework or formal instruction. This is different from the basic sciences, where a significant portion of scientific growth happens in the lab, where one can learn techniques while actively working on projects. The MD-only, physician-researchers I met often did applied, technical, coding-based work, and expressed finding it difficult to obtain independent authority to head projects solely on the basis of lack of research credentials and formal training within health policy.

MD-MPH

I have a number of friends pursuing an MPH alongside an MD/DMD/graduate degree in healthcare. When I ask why, the answer I get usually involves being more informed about health equity, policy, and advocacy. Similarly, the coursework typical of most MPH programs reflects this intention. MPHs are designed to expose students to a wide range of public health disciplines, including epidemiology, biostatistics, health policy, and economics. At the culmination of an MPH program, graduates are often fluent in the general language of public health but much less so in the technical aspects of research itself. After looking through lots of MPH curricula at various different institutions, I realized that an MPH alone would not satisfy my thirst for research training.

MD-Master's

Many schools now offer a Master’s in Health Policy that can be seamlessly integrated with the standard MD curriculum or even with the practice schedule of a resident/attending physician. The MD + MSHP physician-scientists I spoke with had received training in epidemiology, biostatistics, and health economics similar to what an MPH would receive. However, MD + MSHP physician-scientists received more research-focused training and mentorship. As part of the MSHP, they may receive more support to write grants and conduct research than an MPH student part of a large cohort. As attendings, their research credentials enable them to conduct research up to 1-2 days per week.

My appraisal of the research conducted by MD + MSHP physician-scientists was that it was still applied-focused and lacked the foundational training in methods that I was most eager about. For example, most of the MD + MSHP scientists I spoke with had conducted work utilizing difference-in-differences modeling, a common reduced-form econometric technique. Yet it became quickly apparent that their knowledge of the methods came solely from applied use as opposed to the theory of why difference-in-differences works for causal evaluation in the first place. This is not necessarily a negative——scientists doing applied research are important for the advancement of the field. Working in research for the past two years, I just found that I wanted more expertise in theory, methods, and empirics than an MSHP would be able to offer me.

PhD-Only

Most PhD-only faculty are well-trained in research and empirical methods during their PhD. The career trajectory of an academic is relatively straightforward——take an entry-level professor position, make progress on a research agenda for a couple of years, go up for tenure, and either secure it or move institutions if you don’t. This doesn’t require as much of the “balancing act” between research and medical practice that MDs interested in research have to navigate. PhD training is difficult and far more heterogeneous amongst trainees as compared to an MD. However, you come out with a strong foundational knowledge in both theory and applied research, which can be applied to a wide variety of specific research topics as your future dictates.

I got a lot of insight into what PhD-student life was like while working as an undergraduate research assistant for a graduate student. I spent a lot of time hearing about her day-to-day schedule, hearing about what she was learning, and the challenges she faced when it came to investigating her own research questions and writing her dissertation. Later, I learned more about the PhD job market process and came to better appreciate the flexibility that an MD/PhD would have in seeking academic (or even non-academic!) appointments.

MD-PhD

My interest in the MD/PhD training pathway began when I read an economics paper written by an MD/PhD. At this point, I knew that I wanted to pursue a PhD in health policy/economics, and did not know that I could integrate the MD alongside my research training. After doing some more digging, I reached out to an MD/PhD in health policy. Talking to him about what his research and clinical practice looked like on a weekly basis and discussing his role in developing his own research agenda excited me. He attributed his success as a researcher to having completed a PhD, but also conveyed that he felt his clinical perspective greatly enriched his research. Furthermore, he loved seeing patients in the clinic, which he did once a week.

Speaking with this physician-scientist was a validating experience for me. For the first time, I felt that I had found another person with a passion for health economics and clinical work that matched my own!

There’s a lot of flexibility that the MD/PhD confers, particularly in where you end up working post-residency. MD/PhDs in health policy/economics have gone on to pursue academic appointments, industry jobs, work for the government, and much more. Moreover, you often do not have to pay tuition as an MD/PhD student, further lowering the monetary barrier to pursuing both degrees. The combination of all of these factors——depth of training, flexibility, free tuition, lifestyle and research-clinical practice balance——was what sealed the deal on MD/PhD for me. I consulted with many friends, family members, and mentors when making this decision to ensure that it was the right fit for me.